Traditionally, the public health system has been a vital resource for disadvantaged communities and families. Its unique ability to provide population based solutions to health problems has been essential to promoting and protecting the health of the underserved. However, market forces are significantly changing the financial base and functional role of the public health departments. As a result policy makers at all levels of government are looking for ways to provide leaner more efficient service delivery. A popular strategy is the privatization of public health services. The purpose of this study is to look at how privatization affects cost and access to public health services in nine of Florida's largest counties through exploring the following research questions: What are the costs of primary care services provided by contracted services providers relative to services provided by the public health department? Where primary care services have been privatized, what is the effect on access to care for the Medicaid and uninsured patients? What is the effect of privatization on health outcomes in privatized versus non-privatized counties? [unreadable] [unreadable]